ArticlePloS one2018
Access to primary care for socio-economically disadvantaged older people in rural areas: A qualitative study.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Attributes of family physician encounters valued by older adults: a systematic review.BMC primary care · 2025Pooled it
- Older People's Help-Seeking Behaviors in Rural Contexts: A Systematic Review.International journal of environmental research and public health · 2022Pooled it
- A scoping review of how the candidacy framework has been used in research on access to general practice.Journal of health services research & policy · 2026Article
- How Cancer Online Support Groups Work, for Whom, and in What Circumstances: Realist Review.Journal of medical Internet research · 2026Review
- Decisions to Access Health Care: Voices From Rural Residents in Southeast Australia.The Australian journal of rural health · 2026Article
- Neighborhood Deprivation Associated with Impaired Sit-to-Stand Performance in Middle-Aged and Older Adults: A Cross-Sectional Analysis with Clinical Implications.Healthcare (Basel, Switzerland) · 2026Article
- A cross-sectional study of factors influencing sexual health among spouses of patients with cervical cancer.PloS one · 2025Article
- Primary healthcare services' accessibility and quality under compulsory social health insurance in Kazakhstan.Frontiers in public health · 2024Article
- Addressing health inequalities in Europe: key messages from the Joint Action Health Equity Europe (JAHEE).Archives of public health = Archives belges de sante publique · 2023Article
- Understanding Unmet Care Needs of Rural Older Adults with Chronic Health Conditions: A Qualitative Study.International journal of environmental research and public health · 2023Article
- Article
- Associations between Perception of Help-Seeking Behaviors and Quality of Life among Older People in Rural Communities: A Cross-Sectional Study.International journal of environmental research and public health · 2022Article
- Content Validity of a Scale Designed to Measure the Access of Older Adults to Outpatient Health Services.International journal of environmental research and public health · 2022Article
- The need to study rural cancer outcome disparities at the local level: a retrospective cohort study in Kansas and Missouri.BMC public health · 2021Article
- Solving Social Problems in Aging Rural Japanese Communities: The Development and Sustainability of the Osekkai Conference as a Social Prescribing during the COVID-19 Pandemic.International journal of environmental research and public health · 2021Article
- Changes in the Comprehensiveness of Rural Medical Care for Older Japanese Patients during the COVID-19 Pandemic.International journal of environmental research and public health · 2021Observational
- Potential Help-Seeking Behaviors Associated with Better Self-Rated Health among Rural Older Patients: A Cross-Sectional Study.International journal of environmental research and public health · 2021Article
- Article
- What resources do elderly people choose for managing their symptoms? Clarification of rural older people's choices of help-seeking behaviors in Japan.BMC health services research · 2021Article
- Risk of Hospital Readmission among Older Patients Discharged from the Rehabilitation Unit in a Rural Community Hospital: A Retrospective Cohort Study.Journal of clinical medicine · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveWe aim to explore the barriers to accessing primary care for socio-economically disadvantaged older people in rural areas.
methodsUsing a community recruitment strategy, fifteen people over 65 years, living in a rural area, and receiving financial support were recruited for semi-structured interviews. Four focus groups were held with rural health professionals. Interviews and focus groups were audio-recorded and transcribed. Thematic analysis was used to identify barriers to primary care access.
findingsOlder people's experience can be understood within the context of a patient perceived set of unwritten rules or social contract-an individual is careful not to bother the doctor in return for additional goodwill when they become unwell. However, most found it difficult to access primary care due to engaged telephone lines, availability of appointments, interactions with receptionists; breaching their perceived social contract. This left some feeling unwelcome, worthless or marginalised, especially those with high expectations of the social contract or limited resources, skills and/or desire to adapt to service changes. Health professionals' described how rising demands and expectations coupled with service constraints had necessitated service development, such as fewer home visits, more telephone consultations, triaging calls and modifying the appointment system.
conclusionMultiple barriers to accessing primary care exist for this group. As primary care is re-organised to reduce costs, commissioners and practitioners must not lose sight of the perceived social contract and models of care that form the basis of how many older people interact with the service.
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